AccountId: 011433970860
ContactId: 62177ff0-ee2a-4c26-a11a-1fb1ccaeb453
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 201979 ms
Total Talk Time (AGENT): 97675 ms
Total Talk Time (CUSTOMER): 49752 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/23/62177ff0-ee2a-4c26-a11a-1fb1ccaeb453_20250523T17:05_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hello, yes, I'm calling from Baptist Hospital in [PII]. My name is [PII]. Uh, I'm just calling to see what patients currently active with you guys.
[AGENT][NEUTRAL] OK, well, I can definitely help you with the eligibility. And [PII], may I have a good contact number in case we're disconnected and the policy number?
[CUSTOMER][NEUTRAL] [PII] and the policy number is 1861525.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] The Uca Diaz's date of birth is [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment.
[AGENT][NEUTRAL] So this particular policy, hold on one moment.
[AGENT][NEUTRAL] This particular policy is no longer active. Um, it was effective from [PII], but there is an active policy. Um, let me know when you're ready.
[CUSTOMER][NEUTRAL] Is it 2502583437 ML 8?
[AGENT][NEUTRAL] Yes, that's the active policy number. And it's been effective since [PII].
[CUSTOMER][NEUTRAL] Mm, OK.
[CUSTOMER][NEUTRAL] And what does this cover?
[AGENT][NEUTRAL] Um, hold on one moment, let me go to that policy.
[AGENT][NEUTRAL] So this is the member secondary insurance, so we pay towards the copay, deductible and co-insurance of covered charges after primary for outpatient um expenses, the policy will pay up to $2000 per calendar day.
[AGENT][NEUTRAL] Um, so that's emergency room, urgent care, um, diagnostic testing, outpatient surgeries. There is the office treatment rider. So any in-office setting.
[AGENT][NEUTRAL] Um, like if you bill for the facility, it will most likely be denied, but the treatment in the office could be covered with this rider up to the $2000 per day.
[CUSTOMER][NEUTRAL] Uh, and how much has he used?
[AGENT][NEUTRAL] It's per day.
[CUSTOMER][NEUTRAL] Uh, per day, $2000 per day.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] All right. Was there anything else I can assist you with today?
[CUSTOMER][NEUTRAL] Um, no, that will be it. Hold up, give me a sec.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] OK perfect. What would be your name?
[AGENT][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] The first initial to my last name is [PII].
[CUSTOMER][NEUTRAL] And what would be the reference number for this call?
[AGENT][NEUTRAL] There's no call reference number, but you can use my name and today's date.
[CUSTOMER][POSITIVE] Alrighty thank you have a great day.
[AGENT][NEUTRAL] You're welcome. A no thanks for calling [PII]. Bye bye.
[CUSTOMER][NEUTRAL] Bye bye.